Methods :
We retrospectively reviewed the medical records of patients diagnosed as AMD with submacular hemorrhage from January 2008 to January 2017. 29 patients with breakthrough VH after intravitreal anti-VEGF injection in AMD with submacular hemorrhage were enrolled. An age- and sex-matched control group patients were obtained who did not developed breakthrough VH after intravitreal anti-VEGF injection. We compared past medical history, anticoagulant medication, visual acuity, subtype of AMD, type of anti VEGF-agent, and size of submacular hemorrhage to identify possible risk factors between two groups.

Results :
The mean age was 70.4 ± 10.9 years in breakthrough VH group. In 29 patients, 6 patients were diagnosed as choroidal neovascularization(CNV), 22 patients were diagnosed as polypoidal choroidal vasculopathy(PCV) and 1 patients were diagnosed as retinal angiomatous proliferation(RAP). PCV was associated with a significantly higher incidence of VH (odds ratio, 14.91; p=0.001). The size of submacular hemorrhage was 23.69 ± 12.19 disc area (DA) in breakthrough VH group and 5.45 ± 6.93 DA in control group. The size of submacular hemorrhage was significantly positively related to the occurrence of VH (p<0.001). The risk of vitreous hemorrhage was significantly higher when anticoagulants were administered (p=0.004). There were no significant difference between the type of anti-VEGF agent.